How One Therapist Billed Medicare for $4M

Wael Bakry says he just has a successful practice

(Newser)
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How can more than $4 million in Medicare money flow through a small doctor's office in Brooklyn? Seeking answers, the New York Times reports on the world of physical therapy—where demand is on the rise, treatments vary wildly by region, and authorities are cracking down on doctors who cheat the system. The Brooklyn doctor, Wael Bakry, insists he's no cheat, saying he actually runs three offices that give a total of 1,950 patients an average of 94 treatments per year. That's more than triple the national average, but Brooklyn physical therapists tend to bill patients more than counterparts around the country.

Why? According to federal authorities, Brooklyn is a hot spot for physical therapists who cheat the system. Factor in aging Baby Boomers who need more medical help, and the comparatively loose guidelines of physical therapy, and it's all too easy: "An area like physical therapy is a bit gray because there’s no set guideline on how much a given patient needs," says a professor who suggests variances may be explained by "more entrepreneurial physicians." A US physical therapist bills on average $49,000 to Medicare annually, so Bakry's numbers do stand out—yet he says he's just successful. Meanwhile, Medicare fraud stories are rife around the 'Net—with an ambulance service indicted in a $1.5 million scheme, Bloomberg News reports, and 10 people charged in a $69.4 million scheme in Houston just last week, the Houston Chronicle reports.

How come this therapist can bill and get paid by Medicare, while Medicare refuses to pay any of my Physical Therapy treatments. Just curious.

janelanejones

Apr 29, 2014 1:27 PM CDT

.....

Tology

Apr 29, 2014 8:14 AM CDT

It's amazing what physical therapists both get paid and charge for the little work they do. I was in physical therapy for two years and all they did was watch me do exercises when they weren't busy on their phones or reading the paper.

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